Differences in the prevalence and risk factors of osteoporosis in chinese urban and rural regions: a cross-sectional study

Miao Zheng; Yanan Wan; Gongwen Liu; Yan Gao; Xiaoqun Pan; Wanxi You; Donglan Yuan; Jianxin Shen; Junhua Lu; Xia Wang; Gangfeng Zheng; Zhiqiang Han; Xinlin Li; Kai Chen; Xiaoxi Xing; Dong Zhang; Chengwei Weng; Qi Wei; Yongqing Zhang; Hua Lin

doi:10.1186/s12891-023-06147-w

Differences in the prevalence and risk factors of osteoporosis in chinese urban and rural regions: a cross-sectional study

BMC Musculoskelet Disord. 2023 Jan 19;24(1):46. doi: 10.1186/s12891-023-06147-w.

Authors

Miao Zheng^#¹, Yanan Wan^#², Gongwen Liu^#³, Yan Gao⁴, Xiaoqun Pan², Wanxi You⁵, Donglan Yuan⁶, Jianxin Shen⁷, Junhua Lu⁸, Xia Wang⁹, Gangfeng Zheng¹⁰, Zhiqiang Han¹¹, Xinlin Li¹², Kai Chen¹³, Xiaoxi Xing¹⁴, Dong Zhang¹, Chengwei Weng¹, Qi Wei¹⁵, Yongqing Zhang¹⁶, Hua Lin¹⁷

Affiliations

¹ The Osteoporosis Clinical Center, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
² Department of Non-Communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China.
³ Department of Orthopedics, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215004, China.
⁴ Department of Orthopedics, The First People's Hospital of Kunshan, Kunshan, 215300, China.
⁵ Department of Chronic Disease Prevention and Control, Luhe District Center for Disease Control and Prevention, Nanjing, 215200, China.
⁶ Department of Nuclear Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
⁷ Department of Chronic Disease Prevention and Control, Suzhou Wujiang District Center for Disease Control and Prevention, Suzhou, 215200, China.
⁸ Department of Chronic Disease Prevention and Control, Chongchuan District Center for Disease Control and Prevention, Nantong, 226001, China.
⁹ Department of Osteoporosis, Third Affiliated Hospital of Nantong University, Nantong, 226000, China.
¹⁰ Department of Chronic Diseases, Jingjiang Center for Disease Control and Prevention, Jingjiang 214500, Beijing, China.
¹¹ Taizhou Hospital of Traditional Chinese Medicine, Taizhou, 225300, China.
¹² Department of Chronic Diseases, Nantong Center for Disease Control and Prevention, Nantong, 214500, China.
¹³ XuYi People's Hospital, Huaian, 211700, China.
¹⁴ Quanshan District Center for Disease Control and Prevention, Xuzhou, 221002, China.
¹⁵ The Osteoporosis Clinical Center, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China. weiqisahsu@outlook.com.
¹⁶ Department of Non-Communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China. zyq6943@163.com.
¹⁷ Department of Orthopedics, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, China. lh2116@126.com.

^# Contributed equally.

Abstract

Background: Bone mineral density (BMD) and prevalence of osteoporosis may differ between urban and rural populations. This study aimed to investigate the differences in BMD characteristics between urban and rural populations in Jiangsu, China.

Methods: A total of 2,711 participants aged 20 years and older were included in the cross-sectional study. Multistage and stratified cluster random sampling was used as the sampling strategy. BMD was measured by the method of dual-energy x-ray absorptiometry (DXA). Data were collected through questionnaires/interview. BMD values at the lumbar spine (L1-L4), femoral neck, total hip, and greater trochanter were collected. Descriptive statistics were used to demonstrate the characteristics of urban and rural participants. Multivariate logistic regression analysis was utilized to analyze the factors that may be associated with osteoporosis in urban and rural populations.

Results: Of these participants, 1,540 (50.49%) were females and 1,363 (42.14%) were from urban. The prevalence of osteoporosis in urban and rural populations was 5.52% and 10.33%, respectively. In terms of gender, the prevalence of osteoporosis was 2.68% in males and 13.82% in females. For menopausal status, the prevalence of osteoporosis was 30.34% in postmenopausal females and 4.78% in premenopausal females. In urban populations, older age [adjusted odds ratio (AOR) = 2.36, 95%CI, 2.35-2.36), hypertension (AOR = 1.37, 95%CI, 1.36-1.37), unmarried (AOR = 4.04, 95%CI, 3.99-4.09), smoking everyday (AOR = 2.26, 95%CI, 2.23-2.28), family history of osteoporosis (AOR = 1.66, 95%CI, 1.65-1.67), dyslipidemia (AOR = 1.05, 95%CI, 1.04-1.05), and higher β-crosslaps (β-CTX) level (AOR = 1.02, 95%CI, 1.02-1.02) were associated with an increased risk of osteoporosis, while males (AOR = 0.04, 95%CI, 0.04-0.04), higher education level (AOR = 0.95, 95%CI, 0.95-0.95), and aquatic product intake (AOR = 0.99, 95%CI, 0.99-0.99) were related to decreased risk of osteoporosis. Similar results were also observed in rural populations, and (all P < 0.05).

Conclusion: The prevalence of osteoporosis in rural populations was higher than that in urban populations, and the factors associated with the risk of osteoporosis were similar in urban and rural populations.

Keywords: Influencing factor; Osteoporosis; Prevalence; Urban and rural.

MeSH terms

Absorptiometry, Photon
Bone Density
China
Cross-Sectional Studies
Female
Humans
Male
Osteoporosis* / diagnostic imaging
Osteoporosis* / epidemiology
Osteoporosis, Postmenopausal*
Prevalence
Risk Factors
Rural Population